| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,486 |
2,226 |
$173K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
411 |
343 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
404 |
330 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,581 |
1,135 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
398 |
223 |
$23K |
| 92558 |
|
1,136 |
1,009 |
$21K |
| 99174 |
|
1,179 |
1,034 |
$17K |
| 96127 |
|
1,648 |
756 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
383 |
136 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
182 |
153 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
642 |
455 |
$8K |
| 96160 |
|
1,171 |
730 |
$7K |
| 99188 |
|
570 |
487 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
232 |
126 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
251 |
38 |
$3K |
| 99215 |
Prolong outpt/office vis |
23 |
20 |
$3K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
77 |
71 |
$2K |
| 99382 |
|
99 |
15 |
$2K |
| 99383 |
|
106 |
15 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
168 |
151 |
$1K |
| 83655 |
|
137 |
124 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
71 |
12 |
$692.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
43 |
35 |
$577.09 |
| 96161 |
|
79 |
52 |
$243.00 |
| 99173 |
|
99 |
36 |
$225.72 |
| 92551 |
|
98 |
35 |
$192.72 |
| 36416 |
|
233 |
28 |
$84.24 |
| 85018 |
|
713 |
373 |
$22.33 |
| 90633 |
|
29 |
27 |
$0.03 |
| 90686 |
|
241 |
231 |
$0.02 |
| 90651 |
|
220 |
193 |
$0.02 |
| 90715 |
|
159 |
146 |
$0.02 |
| 90619 |
|
81 |
77 |
$0.00 |
| 90688 |
|
81 |
63 |
$0.00 |
| 90620 |
|
14 |
14 |
$0.00 |
| 90716 |
|
150 |
42 |
$0.00 |
| 90680 |
|
54 |
49 |
$0.00 |
| 90700 |
|
55 |
45 |
$0.00 |
| 90707 |
|
137 |
29 |
$0.00 |
| 90648 |
|
31 |
30 |
$0.00 |
| 90713 |
|
76 |
68 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
27 |
23 |
$0.00 |
| 90671 |
|
82 |
75 |
$0.00 |
| 90710 |
|
49 |
38 |
$0.00 |
| 90461 |
|
376 |
122 |
$0.00 |